Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess
Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete fr...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/1091932 |
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| author | Ryan K. Dahlberg Mary Elizabeth Lyvers Thomas K. Dahlberg |
| author_facet | Ryan K. Dahlberg Mary Elizabeth Lyvers Thomas K. Dahlberg |
| author_sort | Ryan K. Dahlberg |
| collection | DOAJ |
| description | Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture. The patient’s pain continued to increase in severity over the next several weeks, and he was evaluated by multiple healthcare professionals with no discovered pathology. Approximately 5 weeks following the fall, repeat CT scan and MRI were conducted which then revealed extensive findings of discitis/osteomyelitis at L5–S1 as well as an epidural abscess resulting in severe narrowing of the central spinal canal. Patient underwent emergent decompression laminectomy and discectomy at L5–S1 with evacuation of the epidural abscess. Intraoperative tissue and wound cultures revealed Salmonella enterica serovar Agbeni. The patient recovered well and was discharged on an eight-week regimen of IV ceftriaxone. He has since recovered appropriately with no neurologic deficits. Important takeaways from this case include continuing to work up patients whose pain or condition is not consistent with radiographic findings and the importance of clinical intuition. This case also highlights the use of intraoperative cultures and sensitivities to correctly direct antibiotic management. Lastly, this report adds to the paucity of literature surrounding Salmonella Agbeni-related discitis and epidural abscesses and makes the suggestion that traumatic incidents such as a fall may instigate these infections. |
| format | Article |
| id | doaj-art-314a509fc9794980b3c8d2f3d07ad44c |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Case Reports in Orthopedics |
| spelling | doaj-art-314a509fc9794980b3c8d2f3d07ad44c2025-02-03T05:58:27ZengWileyCase Reports in Orthopedics2090-67492090-67572018-01-01201810.1155/2018/10919321091932Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural AbscessRyan K. Dahlberg0Mary Elizabeth Lyvers1Thomas K. Dahlberg2University of Illinois College of Medicine, Rockford, USAUniversity of Illinois College of Medicine, Rockford, USARockford Pain Center, Rockford, USASalmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture. The patient’s pain continued to increase in severity over the next several weeks, and he was evaluated by multiple healthcare professionals with no discovered pathology. Approximately 5 weeks following the fall, repeat CT scan and MRI were conducted which then revealed extensive findings of discitis/osteomyelitis at L5–S1 as well as an epidural abscess resulting in severe narrowing of the central spinal canal. Patient underwent emergent decompression laminectomy and discectomy at L5–S1 with evacuation of the epidural abscess. Intraoperative tissue and wound cultures revealed Salmonella enterica serovar Agbeni. The patient recovered well and was discharged on an eight-week regimen of IV ceftriaxone. He has since recovered appropriately with no neurologic deficits. Important takeaways from this case include continuing to work up patients whose pain or condition is not consistent with radiographic findings and the importance of clinical intuition. This case also highlights the use of intraoperative cultures and sensitivities to correctly direct antibiotic management. Lastly, this report adds to the paucity of literature surrounding Salmonella Agbeni-related discitis and epidural abscesses and makes the suggestion that traumatic incidents such as a fall may instigate these infections.http://dx.doi.org/10.1155/2018/1091932 |
| spellingShingle | Ryan K. Dahlberg Mary Elizabeth Lyvers Thomas K. Dahlberg Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess Case Reports in Orthopedics |
| title | Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess |
| title_full | Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess |
| title_fullStr | Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess |
| title_full_unstemmed | Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess |
| title_short | Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess |
| title_sort | diagnostic quandary salmonella agbeni vertebral osteomyelitis and epidural abscess |
| url | http://dx.doi.org/10.1155/2018/1091932 |
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